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Individual

THEODORE GLASSMAN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.,

Contact information

Practice address
4802 10TH AVE, BROOKLYN, NY 11219-2916
(718) 283-6301
Mailing address
408 E 92ND ST APT 29C, 29C, NEW YORK, NY 10128-6840
(917) 406-8063

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
220286
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02661609
NY
Enumeration date
09/29/2006
Last updated
07/08/2007
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